Prognostic significance of the systemic immune-inflammation index in patients with extranodal natural killer/T-cell lymphoma

Tao Hai; Wanchun Wu; Kexin Ren; Na Li; Liqun Zou

doi:10.3389/fonc.2023.1273504

Prognostic significance of the systemic immune-inflammation index in patients with extranodal natural killer/T-cell lymphoma

Front Oncol. 2023 Oct 16:13:1273504. doi: 10.3389/fonc.2023.1273504. eCollection 2023.

Authors

Tao Hai¹, Wanchun Wu^{1

2}, Kexin Ren¹, Na Li¹, Liqun Zou¹

Affiliations

¹ Division of Medical Oncology, Cancer Center and State Key Laboratory of Biotherapy, Sichuan University West China Hospital, Chengdu, China.
² Department of Hematology-Oncology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China.

Abstract

Background: The systemic immune-inflammation index (SII) is based on the neutrophil, platelet, and lymphocyte counts, and has been identified as a prognostic marker in multiple types of cancer. However, the potential value of the SII for predicting survival outcomes in patients with extranodal natural killer/T-cell lymphoma (ENKTCL) has not been investigated thus far.

Method: This study included 382 patients with ENKTCL treated with asparaginase-base regimens from 2021 to 2017 in West China Hospital (Chengdu, China). Clinical and demographic variables, as well as the prognostic value of the SII, were analyzed using Cox proportional hazards regression analysis.

Results: The complete and objective response rates were 55.8% and 74.9%, respectively. Patients with high SII were associated with a lower rate of complete response, higher rate of B symptoms, and serum lactate dehydrogenase levels above or equal to the upper limits of normal (p < 0.01). Patients with low SII were linked to better overall survival and progression-free survival than those with high SII (p < 0.01). Patients with early-stage disease or prognostic model for natural killer lymphoma with Epstein-Barr virus, defined as the low-risk group, could be further stratified according to the SII (p < 0.01). Negative prognostic factors were determined using the Cox proportional hazards regression analysis, which identified four variables: Eastern Cooperative Oncology Group performance status score ≥2, Stage III/IV disease, positivity for Epstein-Barr virus DNA in plasma, and high SII. Predictive nomograms for the prediction of 3- and 5-year overall survival, as well as progression-free survival, were constructed based on those four variables. The nomograms demonstrated favorable discriminating power.

Conclusion: The SII is a novel prognostic marker for ENKTCL, which may be used for the prediction of poorer survival in low-risk patients.

Keywords: extranodal natural killer/T-cell lymphoma; nomogram; prognosis; risk group; systemic immune-inflammation index.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.